Rising healthcare costs are increasingly changing the way Americans use the healthcare system, creating both positive and potentially negative effects, according to a survey by the Employee Benefit Research Institute.

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Sixty-three percent of Americans with health insurance coverage reported an increase in the costs they are responsible for paying under their plan in the past year, the survey found. Of these, 81 percent said the increase caused them to try to take better care of themselves; up from 71 percent in 2005. Sixty-six percent of respondents who saw an increase in costs said they are now talking to the doctor more carefully about treatment options and costs, up from 57 percent in 2005.

The survey also found these other changes in the use of the healthcare system because of rising costs:

Nearly two-thirds of respondents said they went to the doctor only for more serious conditions or symptoms (64 percent in 2007; 54 percent in 2005)

Fifty percent said they delayed going to the doctor, compared with 40 percent in 2005, and

Twenty-eight percent said they skipped or did not fill doses of their prescribed medications, up from 21 percent in 2005.

"These results show the impact of rising health care costs is widespread and growing," says Dallas Salisbury, EBRI president. "Previous surveys showed rising health care costs were affecting the household finances of many Americans. This year we learned that costs also are influencing how much individuals use the health care system, even to the point of delaying care when that could be harmful. Thus, it should be no surprise that the overwhelming majority of Americans are not satisfied with the costs of health insurance."